April is National Child Abuse Prevention Month. On April 8, 2015, the Mecklenburg County CDSA planted blue and silver pinwheels in front of the Carlton G. Watkins Center to raise awareness and promote a healthy and safe start for all children. As early interventionists, this is a great chance to take a look at what we can do differently in our interactions with families and children to help prevent child abuse. Although not all of the children that we serve have experienced abuse, many of the families that we see are facing high levels of stress. For some families, this can lead to a more impactful type of stress, called toxic stress. This type of stress can be the result of a variety of factors, like poverty or homelessness, and often occurs in children experiencing abuse or neglect. Simply experiencing toxic stress as a child can have far-reaching effects.

So what is toxic stress? Every child in the world experiences a varying level of stress in his or her life. Some stress is healthy, like the first day at daycare, and helps children learn to calm themselves with help from caregivers. Hormones and heart rate are briefly elevated and then return to a normal state. There are other stressors that are tolerable, but longer lasting, such as the death of a family member. In these situations, the child’s stress response is more intense and then decreases in response to a supportive caregiver until it returns to normal. In situations of toxic stress, though, the stress response system is activated more often and for longer periods of time, and without buffering from a responsive caregiver, the child is unable to bring his or her stress level down. Imagine a time when your “fight, flight, or freeze” response was activated. Your body released massive amounts of hormones, preparing you to respond to the danger you were experiencing. Now, imagine walking around every second of every day with that heightened response. Your heart rate remains high, and you are always on alert. Sounds pretty scary, right? Children experiencing toxic stress are forced to learn how to operate within this heightened stress level because their bodies never learn how to return them to equilibrium. So what happens to a child as a result of this level of stress?

It’s often thought that children under the age of three are too young to be affected by their experiences and that these early experiences have little impact on the adult they become. This thought couldn’t be further from the truth. Children under the age of 3 account for more than 25% of children abused each year. Regularly high levels of stress hormones have the capability to alter the structure of the brain and impact vital organs. Since children’s brains develop so rapidly during this period, these systems are forced to adapt to the environment around them and get rid of systems they cannot use. These changes during early development can impact behavior, social relationships, and even the physical health of that person in adulthood. With such a high cost for the impact of stress in early childhood, what can we, as early intervention providers, do to support families with strategies to buffer these effects?

Partnering with parents and caregivers experiencing stressful life situations, like poverty, homelessness, and domestic violence, involves a two-fold strategy to help them strengthen their relationship with their child and learn to meet their basic needs. When families are provided with access to resources and are able to meet their basic needs (i.e. food, shelter, clothing), they may feel more able to provide the supportive environment their child needs to help buffer stress and thrive. Another buffer to toxic stress is creating a consistent routine. This can help a child’s overall stress to decrease since the child knows what to expect next in the day, and discussing family routines is already a regular part of early intervention. We need to support families during their routines and can even help create a schedule if it’s a priority for the family.

It is not necessary to be a mental health professional to help families build nurturing relationships with their children. Quality interactions are the best buffer against the effects of toxic stress, so what specifically can we do to begin to support these interactions and help create this buffer? A foundation of the relationship between children and their parents or caregivers is in simple interactions, like talking and playing with their babies and responding when they cry. By supporting parents in a non-judgmental manner through basic interactions with their child, we can help build healthy relationships early on. When children can learn to rely on their parent or caregiver to provide a consistent response to their needs, they are able to learn healthy coping skills. While out visiting with families, there are often lots of opportunities to comment on positive interactions to build up a parent’s confidence and capacity. When you notice that a parent does a nice job comforting her child, playing with her child, or following her child’s lead, comment on the interaction and share that she’s doing a good job. So many of the parents that we see struggle with feeling like they’re not doing a good job, and hearing that encouragement can offer positive reinforcement. By supporting families through these basic interactions in the beginning, we can help change outcomes for families and hopefully prevent future abuse.

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